Method of controlling IOL passage through a cartridge

ABSTRACT

A rear-loaded injector cartridge for an intraocular lens (IOL) having a proximal opening that provides a haptic slot. The haptic slot receives a leading haptic of an IOL loaded therein, and temporarily retains the leading haptic while the optic of the IOL is inserted into a holding area of the cartridge. As the optic passes by, the leading haptic folds over the top of the optic, on its anterior side. The length of the haptic retention slot is sufficient to maintain the leading haptic in its anteriorly folded position while the IOL remains in holding area, typically while the cartridge is mated with a handpiece of the injector. The cartridge also has a rear or proximal cut out which advantageously keys with a similarly-sized rail on the handpiece so that the cartridge cannot be inserted in the wrong way.

RELATED APPLICATIONS

This application is a continuation application of, and claims priorityto, U.S. application Ser. No. 12/111,028 filed on Apr. 28, 2008, whichis hereby incorporated by reference in its entirety.

FIELD OF THE INVENTION

The present invention relates to devices, systems, and methods fordelivering an intraocular lens (IOL) into an eye. More particularly, theinvention relates to devices, systems, and methods for managing passageof an IOL through an injector cartridge.

BACKGROUND OF THE INVENTION

It is estimated that at least about 42% of Americans between the ages of52 and 64 and 73% of Americans between the ages of 65 and 74 getcataracts. A cataract is a clouding of the eye's lens that impairs aperson's vision and, if left untreated, causes blindness. As a result,each year approximately 1.4 million people in the United States aloneundergo cataract surgery, whereby the clouded lens is removed andreplaced with an intraocular lens (IOL) implant.

A typical IOL includes an optic or lens body for focusing light towardthe retina of the eye. In addition, the IOL also includes one or morefixation members or haptics extending outward from the optic forsecuring and centering the IOL in the desired position within thechamber of the eye. The IOL is implanted directly into the eye through asmall incision in a way that reduces trauma and expedites post-surgeryhealing. To fit through this small incision, modern IOLs are designed tobe deformed, e.g., rolled, folded or the like, to a relatively smallprofile and then allowed to return to their original shape within theeye.

A useful technique for inserting an IOL into the eye includes use of anIOL injector or cartridge. Injectors for delivering IOLs into the eyetypically employ a handpiece and a cartridge having a hollow insertiontube or cannula through which the folded IOL is passed using a pushrod.The cartridges are made of disposable materials, such as plastics, andremain in a sterile package until ready for coupling with the handpiece.Some injectors do without the cartridge, and may be reusable.

Conventional IOL cartridges include a load chamber connected to aninjection tube. In many popular versions, such as in U.S. Pat. No.4,681,102 to Bartell or U.S. Pat. No. 5,702,402 to Brady, the loadchamber is formed by two hinged halves which receive the IOL, and whichclose to fold the IOL. A non-folding cartridge is seen in U.S. Pat. No.5,474,562 to Orchowski in which forceps are used to insert the IOL intoa proximal opening of the cartridge. The injection tube includes a smalldiameter distal tip that is insertable into the incision within the eye.After mating the cartridge with the handpiece (if a separate cartridgeis used), the pushrod urges the IOL through the load chamber and theinjection tube into the eye.

In general, the IOL is provided to the surgeon in packaging, such as avial, plastic blister package, or other container for maintaining theIOL in a sterile condition. The IOL is removed from the packaging andplaced on or in the load chamber prior to insertion into the patient'seye. The technique of removing the IOL from the packaging andtransferring it to the load chamber is usually accomplished with a pairof forceps or similar device. The forceps simply place the IOL on or inthe load chamber of the cartridge, or also fold the IOL to a reducedsize for insertion into the eye.

Certain problems may be encountered during delivery of the IOL from thecartridge and into the eye of the subject. For instance, because the IOLis rolled inside the injection tube, the orientation of the optic andhaptic portions may be difficult to control. In addition, problems maybe encountered regarding engagement of the tip of the push-rod with theIOL, resulting in damage of optic, haptics, or both. For instance, theforce required to push the IOL through the injection tube while it foldsfrom contact with tapering walls may cause the rod to slip under or overthe IOL, or to damage the optic.

In view of the above, there is a need for a cartridge that moreeffectively receives and manages passage of an IOL therethrough.

SUMMARY OF THE INVENTION

The present invention solves a number of issues with previousintraocular lens cartridges by including structure to managing passageof an intraocular lens therethrough, and also having a feature thatenables registration with a handpiece in only one orientation.

In accordance with one aspect, the present invention provides a methodof controlling passage of an intraocular lens through an injectorcartridge. An exemplary injector cartridge has a proximal opening sizedto receive an intraocular lens, a hollow interior extendinglongitudinally from the proximal opening to a distal insertion tip, anda holding area within the hollow interior spaced from the proximalopening. The proximal opening is interrupted by a peripheral slot thatextends from the proximal opening in a distal direction and terminatesprior to reaching the holding area. Preferably, the peripheral slotextends distally from the proximal opening a distance of between 3.5-9.3mm. The method also includes providing an intraocular lens having anoptic, a leading haptic, and a trailing haptic, and inserting theintraocular lens into the cartridge through the proximal opening byregistering the leading haptic with the peripheral slot and displacingthe optic of the intraocular lens past the slot and into the holdingarea. In doing so, the leading haptic is guided by the peripheral slotand deforms so as to be located across one face of the optic. Theintraocular lens is then urged from the holding area through the hollowinterior and out of the distal insertion tip. The hollow interior issized to maintain the leading haptic located across one face of theoptic until the intraocular lens emerges from the distal insertion tip.

In accordance with the aforementioned method, the step of inserting theintraocular lens is accomplished using forceps. Also, the cartridge withthe intraocular lens in the holding area is desirably positioned withina handpiece having a pushrod, wherein the step of urging the intraocularlens through the hollow interior of the cartridge comprises extendingthe pushrod through the cartridge and pushing the intraocular lens fromthe holding area through the remainder of the hollow interior. Thecartridge may include an asymmetrically located cutout, wherein themethod includes registering the cutout with corresponding structure onthe handpiece to ensure proper orientation. In one embodiment, the opticof the intraocular lens has a diameter smaller than a width of theproximal opening and larger than the width of the holding area such thatthe optic deforms as it is inserted from the proximal opening to theholding area. The cartridge hollow interior gradually narrows in adistal direction and the intraocular lens undergoes folding into agenerally tubular shape as it passes distally therethrough, wherein thedimensions of the holding area are such that the intraocular lensundergoes a majority of the deformation of folding by the time itreaches the holding area. In one embodiment, the holding area has ahorizontal width of between 2.5-4.5 mm, and the intraocular lens optichas a diameter of at least 5.0 mm.

Another aspect of the present invention is an intraocular lens injectorcartridge for controlling passage of an intraocular lens having anoptic, a leading haptic, and a trailing haptic. The cartridge has acartridge body with a proximal opening sized to receive an intraocularlens and a larger width perpendicular to a central vertical plane thanits height within the vertical plane. A hollow interior of the cartridgeextends longitudinally from the proximal opening to a distal insertiontip, and a holding area within the hollow interior is spaced from theproximal opening. A peripheral slot interrupts the proximal opening andextends from the proximal opening in a distal direction, terminatingprior to reaching the holding area. The peripheral slot is horizontallyoffset so that the proximal opening is asymmetric about the centralvertical plane. Preferably, the peripheral slot extends distally fromthe proximal opening a distance of between 3.5-9.3 mm.

Desirably, the cartridge body further defines an outwardly bulged canopyover the peripheral slot. In a preferred embodiment, the optic of theintraocular lens has a diameter, the horizontal width of the proximalopening is larger than the diameter of the optic and the horizontalwidth of the holding area is smaller than the diameter of the optic,such that the optic deforms as it is inserted from the proximal openingto the holding area. In a particular embodiment, the holding area has ahorizontal width of between 2.5-4.5 mm, and the intraocular lens optichas a diameter of at least 5.0 mm. The cartridge may also include anasymmetrically located cutout, such as a cutout positioned between oneof a pair of finger grips extending horizontally from the cartridge bodyand the cartridge body.

A still further aspect of the present invention is an intraocular lensinjector system for controlling delivery of an intraocular lens havingan optic, a leading haptic, and a trailing haptic, comprising aninjector cartridge body and a handpiece having a pushrod. The cartridgebody has a proximal opening sized to receive an intraocular lens and alarger width perpendicular to a central vertical plane than its heightwithin the vertical plane. A hollow interior extends longitudinally fromthe proximal opening to a distal insertion tip. A holding area withinthe hollow interior is spaced from the proximal opening. A peripheralslot interrupts the proximal opening and extends from the proximalopening in a distal direction, terminating prior to reaching the holdingarea. The peripheral slot horizontally offset such that the proximalopening is asymmetric about the central vertical plane. The handpieceprovides a cradle for receiving the cartridge, wherein the pushrod isaligned in the handpiece to pass longitudinally through the hollowinterior of the cartridge and urge an intraocular lens therethrough.

In a preferred embodiment the cartridge further includes anasymmetrically located cutout, and the handpiece cradle includesstructure for mating with the cutout such that the cartridge can only bereceived in the cradle in one orientation. Preferably, the cartridgefurther includes a pair of finger grips extending horizontally from thecartridge body, wherein the asymmetrically located cutout is positionedbetween one of the finger grips and the cartridge body. In accordancewith one aspect, the hollow interior of the cartridge defines an upperwall and the lower wall along the central vertical plane, wherein theupper wall is generally horizontal, and the lower wall is angled andgradually converges toward the upper wall in a distal direction. Inparticular, the pushrod translates generally longitudinally through thecartridge hollow interior and contacts the angled lower wall midwaytherethrough. For instance, the lower wall may form an angle of greaterthan 0° and up to about 30° with the horizontal, preferably about 20°.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the present invention will be better understood from thefollowing detailed description when read in conjunction with theaccompanying drawings. Such embodiments, which are for illustrativepurposes only, depict the novel and non-obvious aspects of theinvention. The drawings include the following figures, with likenumerals generally indicating like parts:

FIGS. 1 and 2 are perspective top and bottom views, respectively, of anexemplary intraocular lens (IOL) cartridge of the present invention;

FIG. 3 is a top perspective view of the exemplary IOL cartridge from adifferent angle than FIG. 1 and schematically illustrating an IOL heldby forceps just prior to introduction into the cartridge;

FIGS. 4-7 are various plan and elevational views of the exemplary IOLcartridge of the present invention;

FIGS. 8A and 8B are longitudinal sectional views through the exemplaryIOL cartridge taken along lines 8A-8A and 8B-8B of FIG. 4;

FIGS. 9 and 10 are top and bottom plan views, respectively, of theexemplary IOL cartridge;

FIGS. 11A-11E are transverse sectional views through the exemplary IOLcartridge taken along corresponding section lines shown in FIG. 9;

FIG. 12 is a rear plan view of the exemplary IOL cartridge showing anIOL in an initial load position therein;

FIG. 13 is a longitudinal sectional view as in FIG. 8A and showing theIOL in several positions therethrough, including a load position with aleading haptic captured in an upper slot;

FIGS. 14A-14E are transverse sectional views through the exemplary IOLcartridge taken at the same locations as FIGS. 11A-11E and showing anIOL at those locations as it passes through the cartridge;

FIGS. 15 and 16 are top and bottom plan views, respectively, of analternative exemplary IOL cartridge;

FIGS. 17A and 17B are vertical sectional views through the alternativeIOL cartridge taken along corresponding section lines shown in FIG. 15;

FIG. 18 is an elevational view of the alternative IOL cartridge of FIG.15;

FIG. 19 is a horizontal sectional view through the alternative IOLcartridge looking upward along section line 19-19 of FIG. 18;

FIG. 20 is an elevational view of the distal end of the alternative IOLcartridge of FIG. 18; and

FIG. 21 is an elevational view at a slight angle of the proximal end ofthe alternative IOL cartridge of FIG. 18.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Embodiments of the present invention provide a rear- or back-loadedintraocular lens cartridge for use in an IOL injector. As explainedabove, some injectors combine the features of the cartridge andhandpiece in one device, and it should be understood that thedescription herein applies to both separate and such built-incartridges.

Referring to FIGS. 1-3, which shows an IOL cartridge 20 according to anembodiment of the present invention from several perspectives, acartridge 20 includes a main body 22 extending longitudinally from aproximal opening 24 to a distal tip 26. A pair of webs 28 a, 28 bproject transversely outward from opposite sides of the main body 22 andterminates in a generally vertically-oriented finger grip 30 a, 30 b.The finger grips 30 are substantially identical and the left web 28 b isshorter than the right web 28 a, and specifically does not extend as faras the proximal opening 24. As a result, a rearwardly-openinglongitudinal cutout 32 exists on the left side of the cartridge 20between the left finger grip 30 b and the main body 22, seen best inFIG. 3. As will be clearer below, the cutout 32 is asymmetricallylocated about a vertical center line of the cartridge 20 and may beconfigured to mate with a similar male feature on an associatedhandpiece to ensure proper orientation of the cartridge therein. It willbe appreciated that the geometry of the webs 28 a, 28 b and the fingergrips 30 a, 30 b may be modified from the illustrated embodiment to suitthe requirements or preferences of a particular design. For example, thewebs 28 a, 28 b may be made substantially identical so that the webs 28a, 28 b have the same extent.

The main body 22 of the cartridge 20 defines a lumen or hollow interiorextending longitudinally from the proximal opening 24 to a distalopening 34 at the distal tip 26. At the proximal opening 24, the mainbody 22 has a somewhat flattened oval shape interrupted by an uppercanopy 40 and a lower canopy 42 disposed adjacent the opening 24. Inparticular, the periphery of the proximal opening 24 may define amodified oval that generally has a larger horizontal width than itsvertical height. In certain embodiments, for example as seen in FIG. 7,the proximal opening 24 is somewhat bowl-shaped with a convex lower wallthat has a smaller radius than the curvature of the slightly convexupper wall. The perimeter of the proximal opening 24 may have othershapes suitable for receiving an IOL including, but not limited to,rectangular, circular, oval, and the like. In some embodiments, theperimeter of the proximal opening 24 is defined by a shape that includescorner and/or smooth curves free of inflections (e.g., without a changein curvature of a curve from concave to convex or conversely).

The outwardly bulged upper canopy 40 defines therein an upper slot orgroove 44 extending in a distal direction, while the outwardly bulgedlower canopy 42 defines a lower groove 46, also extending distally fromthe opening 24. The periphery of the proximal opening 24 is thusinterrupted twice, once by the upper slot 44 and again by the lowergroove 46—thus defining peripheral openings adjacent the opening 24. Thehollow interior of the main body 22 just inside the proximal opening 24is termed a load chamber 48, as it is where the IOL is first loaded intothe cartridge. With reference to FIGS. 3 and 7, the load chamber 48, theupper canopy 40, and the lower canopy 42 together form a complex openingthat is defined by the proximal opening 24 and adjacent openings formedby the upper and lower canopies 40, 42 that are each offset from theproximal opening 24. The complex opening may be disposed in a singleplane, or along a curved or more complex surface.

FIG. 3 illustrates an IOL held by tongs of forceps 50. This type of IOLincludes a central disc-shaped optic 52, a leading haptic 54, and atrailing haptic 56. Typically, the optic 52 has opposed convex faces,although the present invention is not limited to handling any particulartype of IOL. The haptics 54, 56 are shown as thin arcuate membersextending outward from opposite edges of the optic 52, and generally inthe plane of the optic. The haptics 54, 56 curve in the same direction,in this case a counter-clockwise direction looking down on the IOL.

Other arrangements of haptics around the optic of IOLs are known, andthe present invention is intended to provide a cartridge solution forthe illustrated haptic design as well as others. In particular, IOLshaving leading and trailing haptics often encounter difficulties passingthrough the cartridge with regard to orientation or positioning of thehaptics. If one or both of haptics becomes misaligned or otherwisemispositioned within the cartridge, the IOL may exit the distal tip ofthe cartridge in a manner that requires further positioning within theeye. Desirably, the surgeon controls delivery of the IOL in such a waythat it exits the cartridge in the proper orientation to minimize anyfurther need for repositioning.

With reference still to FIGS. 1-3, and also to the detailed views ofFIGS. 4-8, additional features of the exemplary cartridge 20 will bedescribed. FIG. 4 illustrates the cartridge 20 from above such that theoffset transverse position of the upper canopy 40 is evident. Thesection line 8A-8A extends along a longitudinal center line of thecartridge 20. The cartridge 20 generally exhibits symmetry across avertical plane through this center line, except for the position of theupper canopy 40 and the aforementioned cutout 32.

FIG. 8A shows an exemplary arrangement of the contours of the walls ofthe main body 22, and in particular its hollow interior, along thevertical center line. In the illustrated embodiment, the hollow interiorof the main body 22 defines the load chamber 48. Above and below theload chamber 48 are chambers defined by the grooves 44, 46. Adjacentthereto is a holding area 60 leading to a folding channel 62 that may begradually tapered. In some embodiments, at least one of the grooves 44,46 may border at least a portion of the holding area 60 or even thefolding channel 62. Adjacent the folding channel 62 is a deliverychannel 64 that extends to the distal opening 34. The upper wall of thehollow interior of the cartridge main body 22 extends generally parallelto the horizontal, while the lower and side walls gradually taper inwardin a distal direction. The lower groove 46 within the lower canopy 42may form a slight angle with the horizontal so as to create a graduallynarrowing ramp 66 in the distal direction. The ramp 66 extends into thefolding channel 62, and is adjacent thereto. Other geometries of thehollow interior of the cartridge main body 22 are consistent withembodiments of the IOL cartridge 20.

In certain embodiments, the entire lower wall of cartridge hollowinterior, encompassing the ramp 66, is generally angled and graduallyconverges toward the upper wall in a distal direction. In theillustrated embodiment, the lower wall forms a small angle with thehorizontal; however, this angle may be from 0 degrees to about 30degrees with the horizontal, and is generally between about 5 degreesand about 20 degrees. In other embodiments, the upper wall of theinterior additionally or alternatively is generally angled and graduallyconverges toward the upper wall in a distal direction.

The cartridge is generally configured to mate with a handpiece (notshown) having a pushrod which translates generally longitudinallythrough the cartridge hollow interior and contacts the angled lower wallmidway therethrough. In some embodiments, the pushrod has a forkeddistal end that helps capture the proximal edge of the optic 52.Additionally or alternatively, the distal end of the pushrod may have alower tip that is configured to insert into the lower groove 46, forexample, to help prevent the pushrod tip from riding on top of orunderneath the optic 52 when it is disposed within the cartridge 20.

The slot 44 that interrupts the proximal opening 24 generally extends ina distal direction from the opening 24 and has a length that isgenerally between about 1 mm and 10 mm, preferably between 2 mm and 6mm. In the illustrated embodiment, the slot 44 advantageously terminatesprior to reaching the holding area 60. This arrangement can help ensureproper management of a leading haptic as the IOL passes through thecartridge, as will be explained below.

In another significant change from cartridges of the prior art, theintraocular lens undergoes folding into a generally tubular shape as itpasses distally therethrough, and the dimensions of the holding area 60are such that the intraocular lens undergoes at least some, and in someembodiments a majority, of the deformation of folding by the time itreaches the holding area. For instance, the holding area 60 has ahorizontal width of between 2.5-4.5 mm, and the intraocular lens optichas a diameter of at least 5.0 mm. To define this feature, the optic ofthe IOL typically folds or rolls into a generally tubular shape, and themajority of deformation of folding may be measured by examining thegeometry of the folded optic. In other words, the optic begins generallyflat, and may deform into a rolled circle wherein the side edges thatfold up and touch are oriented 180° from their relaxed orientation. Inthis simple example, a majority of fold deformation has occurred whenthe side edges have folded 90° or more. It should be understood finalconfiguration of the optic may be more or less circular, depending onthe size of the optic relative to the size of the cartridge lumen.

Each of the finger grips 30 a, 30 b includes a plurality of longitudinalribs to help facilitate handling of the cartridge. A pair of proximalflanges 70 project outward from the finger grips 30 and definestructural features that function as a tactile reference for theproximal end of the cartridge 24 when the cartridge is held by thefinger grips 30.

Use of the exemplary cartridge 20 of the present invention will now bedescribed.

As schematically indicated in FIG. 3, the process begins by insertingthe intraocular lens (IOL) into the proximal opening 24 of thecartridge. Often, a fluid or viscoelastic medium is first introducedinto the hollow interior of the cartridge through the proximal opening24 to facilitate passage of the IOL therethrough. Typical intraocularlenses have optic diameters of at least 5.0 mm, and the proximal opening24 is sized to easily receive the intraocular lens. For example, theproximal opening 24 has a horizontal width of at least 6 mm such thatthe IOL can be inserted therethrough in a horizontal orientation withouttouching the opening.

As the IOL enters the proximal opening 24, the operator, using forceps50 or the like, registers the leading haptic 54 with the upper slot 44.Further passage of the IOL into the load chamber 48 causes the leadinghaptic 54, constrained by the peripheral slot, to deform across one faceof the optic, typically the anterior face, as seen in FIGS. 12, 13, and14A. The ramp configuration of the inner wall of the canopy 40facilitates a gradual folding of the leading haptic 54 in this mannerAdditionally, as seen in FIGS. 7 and 11A, the slot 44 is generallytrapezoidal in cross-section section, with a larger upper dimension.This helps trap the filament-like haptic 54 therein, and ensures that itremains in the slot 44 as the optic 52 passes there under.

The operator passes the IOL through the load chamber 48 and into theholding area 60, as seen in FIGS. 13 and 14B. As mentioned above, theholding area 60 has a horizontal width that is less than the diameter ofthe optic 52. This causes the lateral edges of the optic 52 to contactthe sides of the holding area 60. Because of the bowl-shape of thelead-in load chamber 48 and holding area 60, the lateral edges of theoptic 52 fold or curl upward relative to the center. The lower groove 46helps in this folding process by providing relief into which the centralarea of the optic may deform. Desirably, the holding area 60 has asubstantially constant horizontal width along a length of at least 4 mm,preferably between 4-8 mm, and most preferably approximately thediameter of the particular optic 52. For example, a common opticdiameter is 6 mm, so the holding area 60 also has a substantiallyconstant horizontal width of at least 6 mm. As the optic 52 passesthrough the cartridge 20, therefore, the hollow interior first narrowsfrom the proximal opening 24 to the holding area 60, curling the optic,then remains constant in the holding area for the optic to rest, andthen narrows further distally to the distal tip 26. More generally, theholding area 60 has a constant cross-section along its length when thelower groove 46 is excluded.

One benefit of the reduced size holding chamber is that a majority ofIOL folding occurs therein and thus less of the push force applied bythe pushrod to the lens is needed for subsequent folding. In an examplewhere the holding area 60 has a horizontal width of 50-75% of thediameter of optic, the optic effectively curls into its delivery shapeby the time it reaches the holding area. This helps reduce damage to theoptic or slippage of the rod past the IOL. One function of thesubstantially cylindrical and constant cross-section holding area 60 isto provide a sanctuary of sorts for the lens to remain in a stableposition between proximal and distal funnels within the cartridge.

Furthermore, the slot 44 terminates prior to reaching the holding area60 which reduces the vertical dimension above the optic 52. By thistime, the leading haptic 54 is trapped above the optic 52 and remains sobecause of the close spacing there above. The trailing haptic 56presents less of the problem to the operator, as it resilientlystraightens out through the cartridge and resumes its original shapeonce the IOL exits the distal tip 26.

At this point, the operator mates the cartridge 20, having the IOLwithin the holding area 60, with the handpiece of the injector. Asmentioned above, the asymmetrically offset cutout 32 registers with asimilar male feature on the handpiece to ensure proper orientation ofthe cartridge therein.

The operator then urges the IOL from the holding area 60 through thehollow interior of the cartridge 20 and out of the distal insertion tip26, as seen in FIGS. 13 and 14C-14E. The hollow interior graduallynarrows and further reduces the profile of the IOL for passage into anincision in the eye. The tapered folding channel 62 provides atransition from the bowl shapes of the load chamber 48 and holding area60 to the circular cross-sections of the delivery channel 64 and distalopening 34. Moreover, the hollow interior is sized to maintain theleading haptic 54 located across one face of the optic 52 until the IOLemerges from the distal insertion tip. In this manner, the operatormaintains maximum control of the IOL and the leading haptic 54.

With reference now to FIGS. 15-21, an alternative exemplary IOLcartridge 120 similar to the first-described cartridge is shown. Asbefore, the cartridge 120 includes a main body 122 extendinglongitudinally from a proximal opening 124 to a distal tip 126. Each ofa pair of webs 128 a, 128 b projects transversely outward from oppositesides of the main body 122 and terminates in a generallyvertically-oriented finger grip 130 a, 130 b. A rearwardly-openinglongitudinal cutout 132 exists on the left side of the cartridge 120between the left finger grip 130 b and the main body 122.

The main body 122 of the cartridge 120 defines a lumen or hollowinterior extending longitudinally from the proximal opening 124 to adistal opening 134 at the distal tip 126. At the proximal opening 124,the main body 122 has a somewhat flattened oval shape interrupted by anupper canopy 140 and a lower canopy 142. In particular, the proximalopening 124 may define a modified oval having a larger horizontal widththan its vertical height. Alternatively, the proximal opening 124 mayhave any of the shapes discussed above with regard to the proximalopening 24. The outwardly bulged upper canopy 140 defines therein anupper slot 144 extending in a distal direction, while the outwardlybulged lower canopy 142 defines a lower groove 146, also extendingdistally from the opening 124. The periphery of the proximal opening 124is thus interrupted twice, once by the upper slot 144 and again by thelower groove 146—which therefore define peripheral slots.

FIGS. 17A and 17B show the longitudinal vertical contours of the wallsof the main body 122, and FIG. 19 shows the horizontal mid-planecontours. The hollow interior begins with a load chamber 148 just insidethe proximal opening 124 where the IOL is first loaded into thecartridge. Adjacent thereto is a holding area 160 leading to a graduallytapering folding channel 162, and finally to a delivery channel 164 thatextends to the distal opening 134. The bounds of the holding area 160are best seen in FIG. 19. The upper wall of the hollow interior of thecartridge main body 122 extends generally parallel to the horizontal,while the lower and side walls taper inward in a distal direction. Theload chamber 148, the upper canopy 140, and the lower canopy 142together form a complex opening that is defined by the proximal opening124 and adjacent proximal openings formed by the upper and lowercanopies 140, 142 that are each offset from the proximal opening 124.The complex opening may be disposed in a single plane, or along a curvedor more complex surface.

The lower groove 146 within the lower canopy 142 may define a portion ofthe load chamber 140. The lower groove 146 extends generallyhorizontally until reaching a ramp 166 that tapers inward in the distaldirection, generally at an angle of between about 15-30°, and preferably20°. The ramp 166 extends into the folding channel 162, and may form apart thereof.

In contrast with the first embodiment, the lower wall of cartridgehollow interior is generally horizontal until the ramp 166, where itconverges relatively quickly toward the upper wall. Ultimately, thecartridge mates with a handpiece (not shown) having a pushrod whichtranslates generally longitudinally through the cartridge hollowinterior and contacts the ramp 166 midway therealong. Again, the pushrodmay have a forked distal end that helps capture the proximal edge of theoptic.

The slot 144 that interrupts the proximal opening 124 desirably extendsin a distal direction and terminates prior to reaching the holding area160. For instance, the slot 144 in the illustrated embodiment extendsdistally from the proximal opening 124 a distance of about 4 mm, whilethe holding area 160 commences at a distance of about 9 mm from theproximal opening 124. This arrangement may help ensure proper managementof a leading haptic as the IOL passes through the cartridge, asexplained above.

As before, the intraocular lens undergoes folding into a generallytubular shape as it passes distally therethrough, and the dimensions ofthe holding area 160 are such that the intraocular lens undergoes atleast some deformation of folding by the time it reaches the holdingarea. For instance, the holding area 160 has a horizontal width ofbetween 2.5-4.5 mm, and the intraocular lens optic has a diameter of atleast 5.0 mm.

Advantageously, the holding area 160 has a substantially constanthorizontal width along a length of at least 4 mm, preferably between 4-8mm, and most preferably approximately the diameter of the particularoptic. For example, a common optic diameter is 6 mm, so the holding area160 also has a substantially constant horizontal width of at least 6 mm.More generally, the holding area 160 has a constant cross-section alongits length (e.g., when the lower groove 146 is excluded).

The present invention provides a cartridge where the horizontal width ofthe opening into the load chamber 148 is greater than or equal to theoptic lens diameter, while the width of the holding area 160 is lessthan the lens diameter, thus compressing the lens at least slightly. Asthe optic passes through the cartridge 120, therefore, the hollowinterior first narrows from the proximal opening 124 to the holding area160, curling the optic, then remains constant in the holding areaproviding a place for the optic to pause, and then narrows furtherdistally to the distal tip 126. This can best be seen in FIG. 20. Thelens remains slightly compressed in the holding area 160 while in thecartridge 120 until the time of insertion into the eye. One advantagesof this is to maintain a stable and repeatable lens configuration justprior to insert, and subsequently a smooth deformation of the lens uponinsertion during surgery.

The above description represents the best mode contemplated of carryingout the present invention, and of the manner and process of making andusing it, in such full, clear, concise, and exact terms as to enable anyperson skilled in the art to which it pertains to make and use thisinvention. This invention is, however, susceptible to modifications andalternate constructions from that described above which are fullyequivalent. Consequently, it is not the intention to limit thisinvention to the particular embodiments disclosed. On the contrary, theintention is to cover modifications and alternate constructions comingwithin the spirit and scope of the invention as generally expressed bythe following claims, which particularly point out and distinctly claimthe subject matter of the invention.

What is claimed is:
 1. A method of controlling passage of an intraocularlens through an injector cartridge, comprising: providing an injectorcartridge having a proximal opening sized to receive an intraocularlens, the proximal opening generally defining a modified oval that has alarger horizontal width than its vertical height and has oppositelateral corners that generally exhibit symmetry about a central verticalplane, a hollow interior extending longitudinally from the proximalopening to a distal insertion tip, and a holding area within the hollowinterior spaced from the proximal opening, the proximal opening beinginterrupted by a peripheral slot that extends from the proximal openingin a distal direction and terminates prior to reaching the holding area;providing an intraocular lens having an optic, a leading haptic, and atrailing haptic, the optic having a diameter that is smaller than thehorizontal width of the proximal opening of the injector cartridge;inserting an intraocular lens into the cartridge through the proximalopening by registering the leading haptic with the peripheral slot anddisplacing the optic of the intraocular lens past the slot and into theholding area, wherein the leading haptic is guided by the peripheralslot and deforms so as to be located across one face of the optic; andurging the intraocular lens from the holding area through the hollowinterior and out of the distal insertion tip, wherein the hollowinterior is sized to maintain the leading haptic located across one faceof the optic until the intraocular lens emerges from the distalinsertion tip.
 2. The method of claim 1, wherein the peripheral slotextends distally from the proximal opening a distance of between 2.0-6.0mm.
 3. The method of claim 1, further including deforming the opticwhile inserting the intraocular lens into the cartridge through theproximal opening.
 4. The method of claim 1, further includingpositioning the cartridge with the intraocular lens in the holding areawithin a handpiece having a pushrod, wherein the step of urging theintraocular lens through the hollow interior of the cartridge comprisesextending the pushrod through the cartridge and pushing the intraocularlens from the holding area through the remainder of the hollow interior.5. The method of claim 4, wherein the cartridge further includes anasymmetrically located cutout, and the method includes registering thecutout with corresponding structure on the handpiece.
 6. The method ofclaim 1, wherein the optic of the intraocular lens has a diameter largerthan the width of the holding area such that the optic deforms as it isinserted from the proximal opening to the holding area.
 7. The method ofclaim 6, wherein the cartridge hollow interior gradually narrows in adistal direction and the intraocular lens undergoes folding into agenerally tubular shape as it passes distally therethrough, and whereinthe dimensions of the holding area are such that the intraocular lensundergoes folding by the time it reaches the holding area.
 8. The methodof claim 7, wherein the holding area has a horizontal width of between2.5-4.5 mm, and the intraocular lens optic has a diameter of at least5.0 mm.
 9. The method of claim 7, wherein the holding area has asubstantially constant horizontal width along a length of at least 2 mm.10. The method of claim 1, wherein the proximal opening is bowl-shapedwith a convex lower wall that has a smaller radius than the curvature ofa slightly convex upper wall.
 11. The method of claim 1, wherein thehollow interior from the proximal opening to the holding area comprisesa load chamber gradually decreases in size to begin folding the optic ofthe intraocular lens prior to reaching the holding area, and wherein theholding area has a constant cross-section along its length, the methodincluding inserting the intraocular lens into the cartridge until itreaches the holding area using forceps, coupling the cartridge with aninjector handpiece having a pushrod, and further urging the intraocularlens from the holding area through the hollow interior and out of thedistal insertion tip using the pushrod of the injector handpiece. 12.The method of claim 1, wherein the peripheral slot has a generallytrapezoidal cross-section with a larger upper dimension that helps totrap the haptic in the slot so that it deforms and locates across oneface of the optic.
 13. A method of controlling passage of an intraocularlens through an injector cartridge, comprising: providing an injectorcartridge having a proximal opening sized to receive an intraocularlens, the proximal opening defining a bowl-shape that has a largerhorizontal width than its vertical height and a convex lower wallopposite an upper wall, a hollow interior extending longitudinally fromthe proximal opening to a distal insertion tip defining: a load chamberextending from the proximal opening to a holding area, the load chamberhaving converging walls that gradually decrease a cross-section of thehollow interior to define a proximal funnel, the holding area having aconstant cross-section along its length, and a delivery channelextending from the holding area to the distal insertion tip, thedelivery channel having converging walls that gradually decrease across-section of the hollow interior to define a distal funnel,inserting the intraocular lens into the injector cartridge usingforceps, the intraocular lens having an optic, a leading haptic, and atrailing haptic, the optic having a diameter that is smaller than thehorizontal width of the proximal opening of the injector cartridge;displacing the optic of the intraocular lens through the proximal funnelinto the holding area using the forceps to cause the converging walls ofthe load chamber to curl lateral edges of the optic upward relative to acentral area of the optic; coupling the injector cartridge with aninjector handpiece; and advancing a pushrod of the injector handpiece tourge the intraocular lens from the holding area through the distalfunnel and out of the distal insertion tip, wherein the proximal openingof the injector cartridge is interrupted by a peripheral slot in theupper wall that extends from the proximal opening in a distal directionand terminates prior to reaching the holding area, and wherein the stepof inserting an intraocular lens into the injector cartridge usingforceps includes registering the leading haptic with the peripheral slotand displacing the optic of the intraocular lens past the slot and intothe holding area, wherein the leading haptic is guided by the peripheralslot and deforms so as to be located across one face of the optic,wherein the peripheral slot has a generally trapezoidal cross-sectionwith a larger upper dimension that helps to trap the haptic in the slotso that it deforms and locates across one face of the optic.
 14. Themethod of claim 13, wherein proximal opening is off-center in the upperwall.
 15. The method of claim 13, wherein the proximal opening isinterrupted by a second peripheral slot in the convex lower wall thatextends from the proximal opening in a distal direction and terminateswithin the holding area, the second peripheral slot being substantiallysymmetrical about the central vertical plane and facilitating curling ofthe lateral edges of the optic upward relative to the central area ofthe optic by providing a relief into which the central area of the opticmay deform.
 16. The method of claim 13, wherein the injector cartridgehollow interior gradually narrows to a tube and the intraocular lensundergoes folding into a generally tubular shape as it passes distallytherethrough.